1. Field of the Invention
The present invention relates to laparoscopic instruments and, more particularly, to laparoscopic specimen removal apparatuses.
2. General Background
One of the biggest concerns in laparoscopic surgery is the number of laparoscopic instruments required to perform the surgical procedure and thus the number of incisions in the patient to insert such instruments. Therefore, several attempts have been made to integrate the functions of different laparoscopic instruments in such a manner that the number of incisions or trocar sites required to carry out the surgical procedure is minimized. However, any such integration of functions should not complicate the overall surgical procedure but instead simplify.
Before extracting the tissue or specimen from the patient""s cavity, the tissue/specimen is placed in a receptacle such as, a bag, web or sheath to minimize further exposure of the other organs from the possibly diseased tissue/specimen being removed. As can be surmised, the bag or receptacle must be opened and/or deployed and, preferably, closed while in the patient cavity.
Several laparoscopic instruments have been patented which are used to assist in tissue removal during laparoscopic surgery.
U.S. Pat. No. 5,630,822, issued to Hermann et al., discloses a laparoscopic tissue removal device which includes a grasper coaxially mounted within an expandable sheath and including jaws for grabbing a specimen. However, a second tool must be used to tie off the sheath. Additionally, the use of other conventional laparoscopic grasping tools to push the mass into the flared end of the sheath is disclosed.
U.S. Pat. Nos. 5,190,555, issued to Wetter et al.; 5,336,227, issued to Nakao et al.; and, 5,352,184, issued to Goldberg et al. all disclose laparoscopic tools with a bag for capturing tissue, closing the bag via a drawstring and withdrawing it back through the tool.
U.S. Pat. Nos. 5,496,330, issued to Bates; 5,658,296, issued to Bates et al.; and, 5,197,968, issued to Clement all disclose a laparoscopic tools where the tool has a flexible basket for the tissue capture.
U.S. Pat. Nos. 5,176,687, issued to Hasson et al. and 5,312,417, issued to Wilk disclose laparoscopic tools with an open ended bag to capture tissue samples. In the Hasson et al. patent (""687), though a laparoscopic removal tool can be inserted through the bag, the bag must be pulled down out of a sleeve and opened with the assistance of a second tool, such as, forceps. The bag in ""687 is made of a membrane which is not rigid and has no rigid supports to allow it to open on its own inside a patient. In the Wilk patent (""417), the receiver portion or open ended web (bag) is provided with support means to open and expand the open ended web (bag). Numerous proposals are suggested to open the receiver portion or web including complicated techniques using hydraulic or pneumatic circuits. Nevertheless, the invention described in ""417 does not disclose any means in the laparoscopic cannula assembly which serves to close the open end of the web (bag) and, more specifically, the support means supporting the web (bag).
U.S. Pat. Nos. 5,190,1555, 5,336,227, 5,352,184, 5,496,330, 5,312,417, 5,197,968, 5,176,687; 5,630,822, 5,658,296, 5,423,830 are incorporated herein by reference.
U.S. Pat. Nos. 5,465,731 and 5,647,372, both of which are assigned to United States Surgical Corporation, disclose a specimen removal pouch and applicator which includes a pouch closed via a drawstring. An additional forceps or grasper inserted though another cannula may be need to unroll the pouch if necessary. The disclosed specimen removal pouch and applicator is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially through the applicator.
U.S. Pat. No. 5,480,404, issued to Kammerer et al., discloses a surgical tissue retrieval instrument including a collapsible pouch having a cinching mechanism. The instrument of Kammerer et al., like the applicator disclosed in ""731 and ""372, is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially therethrough.
U.S. Pat. No. 5,423,830, issued to Schneebaum et al., discloses an instrument assembly having a capture component including a web member attached to spring biased ribs which opens into a cup-shaped configuration when ejected. A vacuum or suction source is provided to provided a negative pressure to assist in clamping the web member and ribs around the tissue/specimen. The instrument assembly of Schneebaum is not adapted to have the cauterization loop inserted coaxially through the web.
U.S. Pat. No. 5,074,867, issued to Wilk, discloses a membrane or web having stings or filaments attached to the periphery or corners thereof. Forceps or the like are used to stretch the membrane until it assumes a substantially opened position which is shown as a flat sheet-like profile. The strings are used to surround the membrane or web around the specimen or organ.
As can be readily seen, there is a continuing need for a laparoscopic specimen removal apparatus including a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag.
The preferred embodiment of the laparoscopic specimen removal apparatus of the present invention solves the aforementioned problems in a straight forward and simple manner. What is provided is an apparatus for removing specimens from a patient during laparoscopic surgery comprising a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag.
Broadly, the laparoscopic specimen extractor comprises:
(a) a bag having open ends;
(b) a means for supporting said bag having a plurality of tips"" wherein said support means is spring biased and uniquely arranged to automatically open into a tulip shape when ejected to a deployed position;
(c) means coupled to said plurality of tips for cinching closed said support means; and
(d) a pathway, formed coaxially through said laparoscopic specimen extractor and said support means and having said cinching closed means journalled axially therethrough wherein said pathway is adapted to have inserted coaxially therethrough a grasping laparoscopic instrument for retrieving said specimen, adapted to have retracted therethrough said grasping laparoscopic instrument to deposit said specimen in said bag and adapted to aspirate or morcelate said specimen in said bag therethrough.
The support means cinches closed to a generally elliptical or football shape.
In view of the above, it is an object of the present invention to provide a laparoscopic specimen removal apparatus which includes a laparoscopic specimen extractor having a cage lined with a liner or bag which automatically expands and opens to a xe2x80x9ctulipxe2x80x9d shape when deployed and means secured to the cage for cinching closed distal ends or tips of the cage when opened.
Another object of the invention is to provide such a cage or support means with a plurality of spring biased strips having tips wherein a first set of the strip tips are tied together via a first drawstring and a second set of the strip tips are tied togther via a second drawstring. Pulling the first and second drawstrings cinches closed the tips and, thus, the liner or bag attached to the cage.
A further object of the present invention is to provide such a cage or support means which when closed the plurality strips are essentially straight, when opened forms a xe2x80x9ctulipxe2x80x9d shape and when cinched closed forms an xe2x80x9cellipticalxe2x80x9d or xe2x80x9cfootballxe2x80x9d shape.
A further object of the present invention is to provide a support means which include rigid but flexible strips which are secured to the bag.
It is a still further object of the present invention to provide such a laparoscopic specimen extractor with a cinching closed means including first and second drawstrings and a means for pulling the drawstrings simultaneously to cinch close the cage or support means.
It is a still further object of the present invention to provide the cage or support means with a plurality of strips wherein each strip has a free end twisted approximately 90xc2x0 (ninety degrees) with respect to the rest of the strip to form a twisted section and a hole is bored in such twisted section. This twisted section is substantially perpendicular to the center axis of inner tube assembly and thus the cage. Likewise, the center of the holes in the twisted sections is substantially perpendicular to said center axis. Thereby, as the tips (twisted section) is cinched closed via the drawstring the twisted section are drawing toward each other so that an xe2x80x9cellipticalxe2x80x9d or xe2x80x9cfootballxe2x80x9d shape is created.
In view of the above objects, it is a feature of the present invention to provide a laparoscopic specimen extractor which is simple to use and further does not complicate the tissue surgical procedure but instead simplifies it.
Another feature of the present invention is to provide a laparoscopic specimen extractor which is relatively simple structurally and thus simple to manufacture.
A major advantage of the laparoscopic specimen extractor it its utilization of a unique specimen entrapment system which compresses and forms the specimen into a xe2x80x9cdilatorxe2x80x9d or xe2x80x9cfootballxe2x80x9d shaped package in which its cross section""s diameter is much smaller than its length. This aerodynamic shape has the advantage of exiting a smaller incision with significantly less effort than conventional bag type retrieval systems which form the specimen into a xe2x80x9csphericalxe2x80x9d or basketballxe2x80x9d shape which is difficult to pull through a small incision.
Another advantage of the present invention is the ability of the laparoscopic specimen extractor, through a single site, to (1) insert a grasping laparoscopic instrument through (coaxially) the extractors"" center; (2) retrieve a specimen and pull the specimen into the specimen cage/bag assembly via the coaxially inserted grasping laparoscopic instrument; (3) compress the specimen cage/bag assembly into an aerodynamic package; (4) aspirate and/or morcelate the specimen in a protective environment; and, (5) remove the specimen from the patient""s cavity.
The above and other objects, features and advantages of the present invention will become apparent from the drawings, the description given herein, and the appended claims.